Infection oms (1)
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Infection Conception Trait Anatomy Arising Route Mutation Influence factors Diagnosis Principles Treatment Principles
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Infectious agent(bacteria)Infectious agent(bacteria) HostHost
Inflammatory reactionInflammatory reaction
Elimination the infectious pathogenElimination the infectious pathogen Repair tissue injury Repair tissue injury
Hypersensitivity Autoimmune diseaseHypersensitivity Autoimmune disease
Beneficial
Harmful
protective and defensive
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Oral and nasal cavity Tooth Space Blood and Lymphoid system Bacteria
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Oral and nasal cavity Maxillary sinus
Temperature + Moisture
(Beneficial)
Reproduction + Developing
Bacteria---Exist
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Alveolar bone
Soft tissue
Facial space
Alveolar bone
Soft tissue
Facial space
TootToot
hhCaries
Pulpitis
Apical infection
Caries
Pulpitis
Apical infection
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Fascial space ---loose connective tissue
Among skin, maxillary and muscle
•Purulent--- spreading way
•Do not exist in healthy state
•Become filling during infection
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Blood and lymphoid system
Beneficial
Abundance Harmful
Blood and lymphoid system
Beneficial
Abundance Harmful
Dangerous triangle
•Lacking valves
•Cavernous sinus
Dangerous triangle
•Lacking valves
•Cavernous sinus
Cavernous sinus thrombosisCavernous sinus thrombosis
Encephalic infectionEncephalic infection
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Varied Numerous
Streptococcus hemolyticus Staphylococcus aureus Escherichia coli Anaerobe
• Sterile
• Simple
• Complex
• Sterile
• Simple
• Complex
Micro Micro
FloraFlora
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Odontogenic infection
Adenogenous infection
Traumatic infection
Hematogenous infection
Iatrogenic infection
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• Periapical infection
• Pericoronitis
• Periapical infection
• Pericoronitis
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Acute-chronic
Periapical infection
Acute-chronic
Periapical infection
FistularFistular
CellulitisCellulitis
Intraoral soft tissue abscessIntraoral soft tissue abscess
OsteomyelitisOsteomyelitis
SepticemiaSepticemia
Deep fascial space infection
Deep fascial space infection
Ascending facial-cerebral infectionAscending facial-cerebral infection
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Lower third molar Lower third molar
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Local Signs and Symptoms
Systemical Signs and Symptoms
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Pain Swelling Surface erythema Pus formation Limitation of motion
LocallyLocally
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Fever Lymphadenopathy Malaise Toxic appearance Elevated white blood cell count
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Acute stage Chronic stage
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Host Antibiotic therapy Surgical drainage and incision
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Migration of white blood cell Production of antibodies
Most important factor --- final outcome The infections--- cured by the host, not by antibiotics
Critical PrinciplesCritical Principles
Defense MechanismsDefense Mechanisms
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causative organism sensitivity specific, narrow-spectrum antibiotic least toxic antibiotic drug history(success, allergic and toxic)
Antibiotic eraAntibiotic era
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Proper dose Proper time interval Proper route of administration(oral, parenteral) Combination antibiotic therapy
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How to judge the pus formation? Purposes of surgical drainage and incision Principles of surgical drainage and incision
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Three stages
Inoculation
Cellulitis
Abscess
Duration--- >5 days Palpation---Fluctuant Appearance---Reddened Needle aspiration B-ultrasound CT
CharacteristicCharacteristic
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Rid the body of toxic purulent material Decompress the tissues Allowing better perfusion of blood containing antibiotics
and defensive elements Increased oxygenation of the infected area
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Ludwig’s anginaLudwig’s angina
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Place the incision in an esthetically acceptable Place the incision in a dependent position to
encourage drainage by gravity Dissect bluntly through deeper tissues and explore all
portions of the abscess Place a drain and stabilize it with sutures
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Principles of surgical drainage Principles of surgical drainage & incision& incision
Principles of surgical drainage Principles of surgical drainage & incision& incision
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Lesion tooth---Impacted toothLesion tooth---Impacted tooth
OsteomyelitisOsteomyelitis
Chronic stage Chronic stage Chronic stage Chronic stage
Surgical removal of the focusSurgical removal of the focus
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The trait of Infection Odontogenic infection mutation of infectious Diagnosis of the infection Diagnosis of the abscess formation The principles of the treatment
Infection in oral & maxillo-facial region